Radiologic Contrast Media

  • J.-P. Girard
  • L. Gamba
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 63)


The radiographic contrast media currently used in diagnostic medicine are almost all derivatives of triiodobenzoic acid; they have frequently been found to cause unpredictable adverse reactions following intravascular application. As early as 1931, Horsters described a lethal anaphylactic reaction following intravenous injection of such a chemical. A large series of untoward reactions to contrast media was reported by Hultborn (1939), suggesting an allergic mechanism. Such a pathogenic hypothesis was later also proposed by several authors (Dolan 1940; Braunbehrens 1940; Pässler 1952). Up to now, however specific antibodies against contrast media have seldom been found (Bauer and Deutsch 1975; Kleinknecht et al. 1974) and delayed hypersensitivity mechanisms have never been demonstrated.


Histamine Release Allergy Clin Immunol Intravenous Urography Lymphocyte Transformation Test Radiographic Contrast Medium 
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  1. Ansell G (1970) Adverse reactions to contrast agents; scope of problem. Invest Radiol 5:78–84CrossRefGoogle Scholar
  2. Bauer K, Deutsch E (1975) Antikörper-ähnliche Aktivität von monoklonalem IgM-Paraprotein gegen Röntgenkontrastmittel, die 3-Amino-2,4,6-trijodbenzoesäure-Gruppen enthalten. Verh Dtsch Ges Inn Med 81:1224–1226PubMedGoogle Scholar
  3. Bentley P (1968) Liberation of histamine as a mechanism of the toxic action of radiopaque diagnostic agents. PhD thesis, Ann Arbor University MicrofilmsGoogle Scholar
  4. Bernstein EF, Gans H (1966) Anticoagulant activity of angiographic contrast media. Invest Radiol 1:162–168PubMedCrossRefGoogle Scholar
  5. Brasch RC, Caldwell JL (1976) The allergic theory of radiocontrast agent toxicity; demonstration of antibody activity in several patients suffering major radiocontrast agent reactions. Memorial Award Lecture, Association of University Radiologists, BostonGoogle Scholar
  6. Braunbehrens H (1940) Allergische Zwischenfälle bei intravenöser Pyelographie. MMW 3:1203Google Scholar
  7. Cohen LS, Kokko JP, Williams WH (1969) Hemolytic and hemoglobinuria following angiography. Radiology 92:329–332PubMedGoogle Scholar
  8. Cuevas M, Girard JP (1978) Diagnostic et prévention des allergies médicamenteuses aux pénicillines. Actua 10:6Google Scholar
  9. Davies P, Roberts MB, Roylance J (1975) Acute reactions to urographic contrast media. Br Med J 2:434–437PubMedCrossRefGoogle Scholar
  10. Dolan LP (1940) Allergy death due to intravenous use of diodrast; suggestions for possible prevention. JAMA 114:138Google Scholar
  11. Epstein N (1977) Acute reactions to urographie contrast media. Ann Allergy 39Google Scholar
  12. Fischer HW, Doust VL (1972) An evaluation of pre-testing in the problem of serious and fatal reactions to excretory urography. Radiology 13:497Google Scholar
  13. Girard JP, Cattin S, Cuevas M (1976) Immunological mechanisms and diagnostic tests in allergie drug reaction. Ann Clin Res 8:74PubMedGoogle Scholar
  14. Horsters H (1931) Anaphylaktisches Zustandbild nach Injektion von monojodmethansulfosaurem Natrium (Abrodil). Med Klin 27:203Google Scholar
  15. Hultborn KA (1939) Allergische Reaktionen bei Kontrastinjektionen für die Urographie. Acta Radiol 20:263CrossRefGoogle Scholar
  16. Jennings JF (1966) The effect of hydrocortisone on immune lysis of cells induced by cytotoxic antibody and complement in vitro. J Immunol 96:409–414PubMedGoogle Scholar
  17. Kelly JF, Patterson R, Liebermann P, Mathison DA, Stevenson DD (1978) Radiographic contrast media studies in high risk patients. J Allergy Clin Immunol 62:181PubMedCrossRefGoogle Scholar
  18. Kleinknecht D, Deloux J, Hoberg JC (1974) Acute renal failure after intravenous urography: detection of antibodies against contrast media. Clin Nephrol 2:116–119PubMedGoogle Scholar
  19. Lang EK (1965) Clinical evaluation of side-effects of radiopaque contrast media administered via intravenous and intra-arterial routes in the same patients. A preliminary report. Radiology 85:666–668PubMedGoogle Scholar
  20. Lang J, Lasser EC, Talner LB (1974) Inorganic iodide in contrast media. Invest Radiol 9:51PubMedCrossRefGoogle Scholar
  21. Lang J, Walters AJ (1970) Are contrast media histamine releasers? Invest Radiol 5:277Google Scholar
  22. Lasser EC (1968) Basic mechanisms of contrast media reactions. Theoretical and experimental considerations. Radiology 91:63–65PubMedGoogle Scholar
  23. Lasser EC, Lang J (1966) Inhibition of acetylcholinesterase by some organic contrast media. A preliminary communication. Invest Radiol 1:57–69Google Scholar
  24. Lasser EC, Lang J (1970) Physiological significance of contrastprotein interactions. I. Study in vitro of some enzyme effects. Invest Radiol 5:514–518PubMedCrossRefGoogle Scholar
  25. Lasser EC, Walters A, Reuter SR, Lang J (1971) Histamine release by contrast media. Radiology 100:683–686PubMedGoogle Scholar
  26. Lasser EC, Lang J, Sovak M, Kolb W, Lyon S, Hamlin AE (1977) Steroids: theoretical and experimental basis for utilization in prevention of contrast media reaction. Radiology 125:1–9PubMedGoogle Scholar
  27. Lawrence HS (1959) Delayed hypersensitivity and the behaviour of the cellular transfer system in animal and man. In: Shaffer JH, Lo Grippo GA, Chase MW (eds) Mechanisms of hypersensitivity. Henry Ford Hospital International Symposium. Churchill, Livingstone Edinburgh London, p 453Google Scholar
  28. Mann MR (1961) The pharmacology of contrast media. Proc R Soc Med 54:473PubMedGoogle Scholar
  29. Pässler HW (1952) Die Angiographie zur Erkennung. Behandlung und Begutachtung periferer Durchblutungsstörungen. Fortsch Roentgenstr 67Google Scholar
  30. Peters GA, Hodgson JR, Donovon RJ (1966) The effect of premedication with chlorpheniramine on reactions to methylglumine iodipamide. J Allergy 38:74PubMedCrossRefGoogle Scholar
  31. Rockoff SD, Brasch R, Kuhn C, Chraplyvy M (1970 a) Contrast media as histamine liberators. I. Mast-cell histamine release in vitro by sodium salts of contrast media. Invest Radiol 5:503–509PubMedCrossRefGoogle Scholar
  32. Rockoff SD, Brasch R, Kuhn C, Chraplyvy M (1970 b) Contrast media as histamine liberators. II. Histamine release into venous plasma during intravenous urography in man. Invest Radiol 5:510–513PubMedCrossRefGoogle Scholar
  33. Rockoff SD, Brasch R, Kuhn C, Chraplyvy M (1971 a) Contrast media as histamine liberators. III. Histamine release and some associated hemodynamic effects during pulmonary angiography in the dog. Invest Radiol 6:110–114PubMedCrossRefGoogle Scholar
  34. Rockoff SD, Brasch R, Kuhn C, Chraplyvy M (1971 b) Contrast media as histamine liberators. IV. In vitro mast cell histamine release by methylglucamine salts. Invest Radiol 6:186–191PubMedCrossRefGoogle Scholar
  35. Samter M, Beers RS Jr (1968) Intolerance to aspirin — clinical studies and consideration of its pathogenesis. Ann Intern Med 68:975PubMedGoogle Scholar
  36. Sandström C (1955) Secondary reactions from contrast media and the allergy concept. Acta Radiol 44:233–241PubMedCrossRefGoogle Scholar
  37. Schatz M, Patterson R, O’Rourke J, Nickelsen J, Northup C (1975) The administration of radiographic contrast media to patients with a history of a previous reaction. J Allergy Clin Immunol 55/5:358–366PubMedCrossRefGoogle Scholar
  38. Stuhl L, Gillot C, Sotty M (1965) Mise en évidence d’un processus fibrinolytique au cours des intolérances aux produits iodés de contraste et des états allergiques. Nouv Presse Méd 73:2297–2300Google Scholar
  39. Till G, Rother V, Gemsa D (1978) Activation of complement by radiographic contrast media generation of chemotactic and anaphylatoxis activities. Int Arch Allergy Appl Immunol 56:543–550PubMedCrossRefGoogle Scholar
  40. Wakkers-Garritsen BC, Houwerzidi J, Nater JP, Wakkers PJM (1976) IgE-Mediated adverse reactivity to a radiographic contrast medium. Ann Allergy 36:122–126PubMedGoogle Scholar
  41. Witten DM (1966) Micro-autoradiographic study of the distribution of tritiated sodium diatrizoate in the canine kidney. Invest Radiol 1:271CrossRefGoogle Scholar
  42. Witten DM (1975) Reactions to urographic contrast media. JAMA 231Google Scholar
  43. Wolfromm R, Dehouve A, Degaud F, Wattez E, Lang R, Crehalet A (1960) Les accidents graves par injection intraveineuse de substances iodées pour urographie. J Radiol Electrol 47:346Google Scholar
  44. Zweiman B, Miskin MM, Hildreth EA (1975) An approach to the performance of contrast studies in contrast material reactive persons. Arch Intern Med 83:159Google Scholar

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© Springer-Verlag Berlin Heidelberg 1983

Authors and Affiliations

  • J.-P. Girard
  • L. Gamba

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